Speaker: Ellen Stewart, Attorney Spencer Fane LLP
1. Payer Termination Without Cause - Is the new Colorado Law any help? 2. Payer Audit and Compliance Department Government Reporting - The risks are real! 3. Reinsurance Claims - What if the company becomes insolvent? 4. The Difference - "Best Efforts" or "Commercially Reasonable Efforts"? 5. Administrative Manuals - Beware, did you read the fine print?
Speaker: Doral Jacobsen, MBA, FACMPE CEO Prosper Beyond
This session focuses on sharing the story of one practice’s journey in negotiating next generation payer contracts. First, we will set the stage by discussing alternative payment models, defining key elements and identifying core drivers. We will cover essential fundamentals of value based contracting methodologies and discuss approaches for uncovering practice potential. The case study will include a dive deep into how the practice moved through the process including data gathering, analyses, creation of a value proposition and payer relationship building. We will identify sources for determining total cost of care, estimating cost savings and suggestions for how to effectively tell your practice story. This talk will include many tips for payer negotiations and tactile guidance relative to positioning effectively in next generation payer contract negotiations.
Learning Objectives:
